New guidelines urged for H1N1 protection among healthcare employees

Infectious disease experts are calling for a moratorium on OSHA guidelines for health care employees that require the use of fit-tested N95 respirators for personal protection from H1N1 flu. Three leading infectious disease organizations, have written a letter to President Obama citing lack of scientific evidence that N95 respirators offer additional protection from the virus, compared to surgical masks. The scientific groups urge new guidelines for H1N1 flu protection for healthcare workers to prevent “dangerous” consequences.

The Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA) and the Association for Professionals in Infection Control and Epidemiology (APIC) say N95 respirators are in short supply, and there is no evidence they are needed in healthcare settings for personal protection from H1N1 flu.

The Centers for Disease Control and Prevention (CDC) and OSHA recently issued the guidelines for the use of fit-tested N95 respirators by healthcare employees instead of standard surgical masks, but the scientists say there is no need to use the fitted respirators.

According to Richard Whitley MD, president of IDSA, "During a time of a national emergency, healthcare professionals need clear, practical and evidence-based guidance from the government. The current guidance is not supported by the best-available science and only serves to create skepticism toward federal public and occupational health decision-making." Two recent studies show that the N95 respirators offer no additional protection from H1N1 flu, and should be reserved for use when caring for TB patients.

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"The supply of N95 respirators is rapidly being depleted in our healthcare facilities", said APIC 2009 President Christine Nutty, RN, MSN, CIC. "We are concerned that there won’t be an adequate supply to protect healthcare workers when TB patients enter the healthcare system."

A study from McMaster University researchers, published last month in JAMA, showed that surgical masks protect from H1N1 flu as well as the N95 respirators. Dr. Mark Loeb who led the study said, "Given the likelihood that N95 respirators will be in short supply during a pandemic and unavailable in many countries, understanding the relative effectiveness of personal respiratory protective equipment is important.”

Mark Rupp, MD, president of SHEA calls the current guidelines for use of the N95 respirator among health care workers caring for patients with H1N1 flu "deeply flawed", saying the OSHA guidelines are causing confusion among health care workers and hospital administrators.

The infectious disease experts are asking the government to modify the current OSHA guidelines for the use of N95 respirators, given the short supply and lack of scientific evidence that they provide any better protection from H1N1 flu than standard surgical masks. The scientists say the use of the wrong kind of personal protective equipment could have "dangerous consequences" for both patients and healthcare workers.

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